BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3120592 · Received May 20, 2013

    Report

    Report Number
    1525712-2013-03935
    Event Type
    Malfunction
    Date Received
    May 20, 2013
    Report Date
    April 22, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NM, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATES THEY HAVE REPLACED THE TILT ACTUATOR SEVERAL TIMES AND NOW IF THE TILT ACTUATOR COMES BACK DOWN TO ZERO. THE CHAIR IS TURNED OFF AT THE TIME. HE STATES ITS LIKE SLOWLY DROPPING BACK DOWN TO ZERO.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    221993 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET GTQ3-CG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other